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Assessment of Electrocardiographic and Echocardiographic Features in Patients Admitting with Syncope

Year 2017, Volume: 9 Issue: 3, 237 - 242, 22.09.2017
https://doi.org/10.18521/ktd.342578

Abstract

Objective: This study aims to investigate the ECG and ECO parameters in patients admitting to the emergency department with syncope and to
evaluate relationship between ECG and ECHO findings and the cause and feature
of syncope.

Methods: A
total of 90 patients admitted to our emergency department due to syncope
between 01.01.2016-31.12.2016 were included in the study. It is designed as a
prospective cross-sectional case study. Electrocardiographic and
echocardiographic parameters were measured and recorded. The type-1 error level
was determined as 0.05 for statistical significance

Results: Forty
(44.4%) of the patients were female, and
50 (55.6%) were male. The mean age of the
patients was 63,5 years of age. Most of the cases
(%57,8) discharged with a follow-up decision, and 36
patients were hospitalized, and 2.2% of
patients died. When the relationship between the
syncope duration of the patients and the duration of PR, QRS, and QT at the
time of referral and 6th hour were examined, the only relation between QRS
duration and duration of syncope was found statistically significant. Tricuspid
insufficiency (41.1%), mitral regurgitation (37.8%), aortic insufficiency
(18.9), mitral stenosis (6.7%) and aortic stenosis (5.6%) were found to be the
most common cardiac valve diseases in the patients. The mean EF values of the
patients were 50.3% and mean PAP 30.8 mmHg.







Conclusion: The use of ECG and ECHO in all
patients who are referred for syncope is very useful in distinguishing cardiac
syncope patients, diagnosing syncope, and identifying patients at risk.

References

  • 1. Blanc JJ, L’Her C, Touiza A, Garo B, L’Her E, Mansourati J. Prospective evaluation and outcome of patients admitted for syncope over a 1 year period. Eur Heart J 2002;23:815 –820.
  • 2. Blanc JJ, L’Her C, Gosselin G, Cornily JC, Fatemi M. Prospective evaluation of an educational programme for physicians involved in the management of syncope. Europace 2005;7:400 –406.
  • 3. Crane SD. Risk stratification of patients with syncope in an accident and emergency department. Emerg Med J 2002;19:23 –27.
  • 4. Brignole M, Disertori M, Menozzi C, Raviele A, Alboni P, Pitzalis MV, Delise P, Puggioni E, Del Greco M, Malavasi V, Lunati M, Pepe M, Fabrizi D. On behalf of the Evaluation of Guidelines in Syncope Study (EGSYS) group. Management of syncope referred urgently to general hospitals with and without syncope units. Europace 2003;5:293 –298
  • 5. Day SC, Cook EF, Funkenstein H, Goldman L.Evaluation and outcome of emergency room patients with transient loss of consciousness. Am J Med. 1982; 73: 15-23.
  • 6. Strickberger SA, Benson DW, Biaggioni I, Callans DJ, Cohen MI, Ellenbogen KA, et al. AHA/ACCF Scientific Statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: in collaboration with the Heart Rhythm Society: endorsed by the American Autonomic Society. Circulation. 2006;113(2):316-27.
  • 7. Thijs RD, Benditt DG, Mathias CJ, Schondorf R, Sutton R, Wieling W. Unconscious confusiona literature search for definitions of syncope and related disorders. Clin Auton Res 2005; 15: 35-39.
  • 8. Colman N, Nahm K, Ganzeboom KS, Shen WK, Reitsma J, Linzer M, Wieling W, Kaufmann H. Epidemiology of reflex syncope. Clin Auton Res 2004;14(Suppl 1): i9 –i17.
  • 9. Soteriades ES, Evans JC, Larson MG, Chen MH, Chen L, Benjamin EJ, Levy D. Incidence and prognosis of syncope. N Engl J Med 2002;347:878 –885
  • 10. The Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC). Guidelines for the diagnosis and management of syncope (version 2009). European Heart Journal 2009; 30: 2631–2671.
  • 11. J. S. Fits and Faints. . Oxford: Blackwell Scientific Publications. 1990; 41–57.
  • 12. Kenny, Rose Anne, Jaspreet Bhangu, and Bellinda L. King-Kallimanis. "Epidemiology of syncope/collapse in younger and older Western patient populations." 55.4 (2013): 357-363.
  • 13. Role of echocardiography in the evaluation of syncope: a prospective study F P Sarasin, A-F Junod, D Carballo, S Slama, P-F Unger, M Louis-Simonet
  • 14. Predictors of Mortality, Rehospitalization for Syncope and Cardiovascular Events in Patients With Cardiovascular Syncope Tatsuya Onuki, PhD; Makoto Shoji, PhD; Yuya Nakamura, MD; Ko Ogawa, MD; Akinori Ochi, MD; Koichiro Inokuchi, MD; Shiro Kawasaki, PhD; Yoshimi Onishi, PhD; Yoshimasa Onuma, MD; Yumi Munetsugu, MD; Miwa Kikuchi, PhD; Hiroyuki Ito, PhD; Yoshino Minoura, PhD; Norikazu Watanabe, PhD; Taro Adachi, PhD; Mitsuharu Kawamura, PhD; Taku Asano, PhD; Kaoru Tanno, PhD; Youichi Kobayashi, PhD
  • 15. Rich S, Dantzker DR, Ayres SM, Bergofsky EH, Brundage BH, Detre KM, Fishman AP, Goldring RM, Groves BM, Koerner SK. Primary pulmonary hypertension. A national prospective study. Ann Intern Med 1987;107:216 –223.
  • 16. Blanc JJ, L'Her C, Touiza A, Garo B, L'Her E, Mansourati J. Prospective evaluation and outcome of patients admitted for syncope over a 1 year period. Eur Heart J. 2002;23(10):815-
  • 17. Quinn JV, Stiell IG, McDermott DA, Sellers KL, Kohn MA, Wells GA. Derivation of the San Francisco Syncope Rule to predict patients with short-term serious outcomes. Ann Emerg Med. 2004;43(2):224-32.
  • 18. Strickberger SA, Benson DW, Biaggioni I, Callans DJ, Cohen MI, Ellenbogen KA, et al. AHA/ACCF Scientific Statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: in collaboration with the Heart Rhythm Society: endorsed by the American Autonomic Society. Circulation. 2006;113(2):316-27.
  • 19. Crane SD. Risk stratification of patients with syncope in an accident and emergency department. Emerg Med J. 2002;19(1):23-7. 55
  • 20. Huff JS, Decker WW, Quinn JV, Perron AD, Napoli AM, Peeters S, et al. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with syncope. Ann Emerg Med. 2007;49(4):431-44.
  • 21. Maisel WH, Stevenson WG. Syncope--getting to the heart of the matter. N Engl J Med. 2002;347(12):931-3.

Senkop İle Gelen Olgularda Elektrokardiyografik Ve Ekokardiyografik Özelliklerin Değerlendirilmesi

Year 2017, Volume: 9 Issue: 3, 237 - 242, 22.09.2017
https://doi.org/10.18521/ktd.342578

Abstract

Amaç: Bu
çalışmanın amacı senkop ile acil servise gelen hastalarda, EKG ve EKO bulguları
ile senkop nedenini ve senkop özelliklerini ortaya koymak, EKG ve EKO
parametrelerle ilişkisini araştırmaktır.

Gereç ve Yöntem: Acil servisimize 01.01.2016
ile 31.12.2016 tarihleri arasında senkop nedeniyle başvuran toplam 90 hasta
çalışmaya dâhil edilmiştir. Prospektif kesitsel bir vaka çalışması olarak
tasarlanmıştır. Elektrokardiyografik ve ekokardiyografik parametreleri
ölçülerek kaydedildi. İstatistiksel anlamlılık için tip-1 hata düzeyi 0,05
olarak belirlendi.

Bulgular: Hastaların 40’ı (%44,4)
kadın, 50’si (%55,6) erkek idi. Hastaların genel yaş ortalaması 63,5±18,0
olarak saptanmıştır. Olguların büyük çoğunluğu (%57,8) ayaktan takip kararı ile
taburcu edilmiş, 36 hasta hastaneye yatırıldı ve %2,2’si ölümle sonuçlanmıştır.
Hastaların senkop süreleri ile başvuru esnasındaki ve 6. saatteki PR, QRS ve QT
süreleri arasındaki ilişki incelendiğinde sadece QRS süreleri ile senkop süresi
arasında istatistiksel olarak anlamlı ilişki saptanmıştır. Hastalara ait kalp
kapak hastalıkları incelendiğinde sıklık sırasına göre trikuspit yetmezlik (%41.1),
mitral yetmezlik (%37.8), aort yetmezliği (18.9), mitral darlık (%6.7) ve aort
stenozu (%5.6) tespit edilmiştir. Hastaların EF değerlerinin ortalaması %50,3,
ortalama PAB ise 30,8 mmHg idi.







Sonuç: Senkop nedeniyle başvuran tüm
hastalara EKG ve EKO uygulanması kardiyak kökenli senkop hastalarını ayırt
etmek, senkopa neden olan hastalığın tanısını koymak ve riskli hasta grubunu
saptamakta oldukça faydalıdır. 

References

  • 1. Blanc JJ, L’Her C, Touiza A, Garo B, L’Her E, Mansourati J. Prospective evaluation and outcome of patients admitted for syncope over a 1 year period. Eur Heart J 2002;23:815 –820.
  • 2. Blanc JJ, L’Her C, Gosselin G, Cornily JC, Fatemi M. Prospective evaluation of an educational programme for physicians involved in the management of syncope. Europace 2005;7:400 –406.
  • 3. Crane SD. Risk stratification of patients with syncope in an accident and emergency department. Emerg Med J 2002;19:23 –27.
  • 4. Brignole M, Disertori M, Menozzi C, Raviele A, Alboni P, Pitzalis MV, Delise P, Puggioni E, Del Greco M, Malavasi V, Lunati M, Pepe M, Fabrizi D. On behalf of the Evaluation of Guidelines in Syncope Study (EGSYS) group. Management of syncope referred urgently to general hospitals with and without syncope units. Europace 2003;5:293 –298
  • 5. Day SC, Cook EF, Funkenstein H, Goldman L.Evaluation and outcome of emergency room patients with transient loss of consciousness. Am J Med. 1982; 73: 15-23.
  • 6. Strickberger SA, Benson DW, Biaggioni I, Callans DJ, Cohen MI, Ellenbogen KA, et al. AHA/ACCF Scientific Statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: in collaboration with the Heart Rhythm Society: endorsed by the American Autonomic Society. Circulation. 2006;113(2):316-27.
  • 7. Thijs RD, Benditt DG, Mathias CJ, Schondorf R, Sutton R, Wieling W. Unconscious confusiona literature search for definitions of syncope and related disorders. Clin Auton Res 2005; 15: 35-39.
  • 8. Colman N, Nahm K, Ganzeboom KS, Shen WK, Reitsma J, Linzer M, Wieling W, Kaufmann H. Epidemiology of reflex syncope. Clin Auton Res 2004;14(Suppl 1): i9 –i17.
  • 9. Soteriades ES, Evans JC, Larson MG, Chen MH, Chen L, Benjamin EJ, Levy D. Incidence and prognosis of syncope. N Engl J Med 2002;347:878 –885
  • 10. The Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC). Guidelines for the diagnosis and management of syncope (version 2009). European Heart Journal 2009; 30: 2631–2671.
  • 11. J. S. Fits and Faints. . Oxford: Blackwell Scientific Publications. 1990; 41–57.
  • 12. Kenny, Rose Anne, Jaspreet Bhangu, and Bellinda L. King-Kallimanis. "Epidemiology of syncope/collapse in younger and older Western patient populations." 55.4 (2013): 357-363.
  • 13. Role of echocardiography in the evaluation of syncope: a prospective study F P Sarasin, A-F Junod, D Carballo, S Slama, P-F Unger, M Louis-Simonet
  • 14. Predictors of Mortality, Rehospitalization for Syncope and Cardiovascular Events in Patients With Cardiovascular Syncope Tatsuya Onuki, PhD; Makoto Shoji, PhD; Yuya Nakamura, MD; Ko Ogawa, MD; Akinori Ochi, MD; Koichiro Inokuchi, MD; Shiro Kawasaki, PhD; Yoshimi Onishi, PhD; Yoshimasa Onuma, MD; Yumi Munetsugu, MD; Miwa Kikuchi, PhD; Hiroyuki Ito, PhD; Yoshino Minoura, PhD; Norikazu Watanabe, PhD; Taro Adachi, PhD; Mitsuharu Kawamura, PhD; Taku Asano, PhD; Kaoru Tanno, PhD; Youichi Kobayashi, PhD
  • 15. Rich S, Dantzker DR, Ayres SM, Bergofsky EH, Brundage BH, Detre KM, Fishman AP, Goldring RM, Groves BM, Koerner SK. Primary pulmonary hypertension. A national prospective study. Ann Intern Med 1987;107:216 –223.
  • 16. Blanc JJ, L'Her C, Touiza A, Garo B, L'Her E, Mansourati J. Prospective evaluation and outcome of patients admitted for syncope over a 1 year period. Eur Heart J. 2002;23(10):815-
  • 17. Quinn JV, Stiell IG, McDermott DA, Sellers KL, Kohn MA, Wells GA. Derivation of the San Francisco Syncope Rule to predict patients with short-term serious outcomes. Ann Emerg Med. 2004;43(2):224-32.
  • 18. Strickberger SA, Benson DW, Biaggioni I, Callans DJ, Cohen MI, Ellenbogen KA, et al. AHA/ACCF Scientific Statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: in collaboration with the Heart Rhythm Society: endorsed by the American Autonomic Society. Circulation. 2006;113(2):316-27.
  • 19. Crane SD. Risk stratification of patients with syncope in an accident and emergency department. Emerg Med J. 2002;19(1):23-7. 55
  • 20. Huff JS, Decker WW, Quinn JV, Perron AD, Napoli AM, Peeters S, et al. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with syncope. Ann Emerg Med. 2007;49(4):431-44.
  • 21. Maisel WH, Stevenson WG. Syncope--getting to the heart of the matter. N Engl J Med. 2002;347(12):931-3.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Fatih Güneysu

Ayhan Sarıtaş

Harun Güneş

Feruza Turan Sönmez

Semih Güneysu This is me

Publication Date September 22, 2017
Acceptance Date September 13, 2017
Published in Issue Year 2017 Volume: 9 Issue: 3

Cite

APA Güneysu, F., Sarıtaş, A., Güneş, H., Turan Sönmez, F., et al. (2017). Senkop İle Gelen Olgularda Elektrokardiyografik Ve Ekokardiyografik Özelliklerin Değerlendirilmesi. Konuralp Medical Journal, 9(3), 237-242. https://doi.org/10.18521/ktd.342578
AMA Güneysu F, Sarıtaş A, Güneş H, Turan Sönmez F, Güneysu S. Senkop İle Gelen Olgularda Elektrokardiyografik Ve Ekokardiyografik Özelliklerin Değerlendirilmesi. Konuralp Medical Journal. September 2017;9(3):237-242. doi:10.18521/ktd.342578
Chicago Güneysu, Fatih, Ayhan Sarıtaş, Harun Güneş, Feruza Turan Sönmez, and Semih Güneysu. “Senkop İle Gelen Olgularda Elektrokardiyografik Ve Ekokardiyografik Özelliklerin Değerlendirilmesi”. Konuralp Medical Journal 9, no. 3 (September 2017): 237-42. https://doi.org/10.18521/ktd.342578.
EndNote Güneysu F, Sarıtaş A, Güneş H, Turan Sönmez F, Güneysu S (September 1, 2017) Senkop İle Gelen Olgularda Elektrokardiyografik Ve Ekokardiyografik Özelliklerin Değerlendirilmesi. Konuralp Medical Journal 9 3 237–242.
IEEE F. Güneysu, A. Sarıtaş, H. Güneş, F. Turan Sönmez, and S. Güneysu, “Senkop İle Gelen Olgularda Elektrokardiyografik Ve Ekokardiyografik Özelliklerin Değerlendirilmesi”, Konuralp Medical Journal, vol. 9, no. 3, pp. 237–242, 2017, doi: 10.18521/ktd.342578.
ISNAD Güneysu, Fatih et al. “Senkop İle Gelen Olgularda Elektrokardiyografik Ve Ekokardiyografik Özelliklerin Değerlendirilmesi”. Konuralp Medical Journal 9/3 (September 2017), 237-242. https://doi.org/10.18521/ktd.342578.
JAMA Güneysu F, Sarıtaş A, Güneş H, Turan Sönmez F, Güneysu S. Senkop İle Gelen Olgularda Elektrokardiyografik Ve Ekokardiyografik Özelliklerin Değerlendirilmesi. Konuralp Medical Journal. 2017;9:237–242.
MLA Güneysu, Fatih et al. “Senkop İle Gelen Olgularda Elektrokardiyografik Ve Ekokardiyografik Özelliklerin Değerlendirilmesi”. Konuralp Medical Journal, vol. 9, no. 3, 2017, pp. 237-42, doi:10.18521/ktd.342578.
Vancouver Güneysu F, Sarıtaş A, Güneş H, Turan Sönmez F, Güneysu S. Senkop İle Gelen Olgularda Elektrokardiyografik Ve Ekokardiyografik Özelliklerin Değerlendirilmesi. Konuralp Medical Journal. 2017;9(3):237-42.